Night terrors occur when you’re in a deep sleep and involve episodes of intense fear, screaming and flailing. They are relatively uncommon in children and affect a smaller percentage of adults. Night terrors only last for a few seconds or minutes and happen as we progress from one sleep stage to another. Usually there is no cause for concern unless it poses a safety risk or impacts sleep quality.
Night terrors versus nightmares
Night terrors or sleep terrors are similar to nightmares but there are distinct differences.
Nightmares usually occur during the rapid eye movement (REM) stage and a person can recall what happened in the dream upon awakening.
Night terrors happen during a deeper stage of sleep called non-REM. This is why a person doesn’t remember any images when they wake up and often they will remain asleep during and after the episode. A night terror may lead to sleepwalking—another parasomnia.
Night terror symptoms
During an episode of a night terror the person may:
- suddenly sit upright in bed
- scream or shout out in distress
- have faster breathing and a quicker heartbeat
- stare wide-eyed
- sweat
- thrash around
- act scared or frightened
- possibly get out of bed and move around
- be hard to awaken and appear confused when awake
- have no or little recollection of what occurred
Usually night terrors aren’t a cause for concern, but you should consult your doctor if the night terrors result in fatigue during the day, become more frequent and impact sleep quality and duration. Night terrors are also a worrying if they lead to safety concerns or injury.
Why night terrors happen
Night terrors are caused by over-arousal of the central nervous system during sleep. A night terror is not technically a dream, but more like a sudden reaction of fear that happens during the transition from one sleep stage to another. They usually happen a few hours after falling asleep as we move from the deepest stage of REM sleep to a lighter REM sleep. Usually the transition is a smooth one, but sometimes a person can become anxious and that fear reaction manifests as a night terror.
Night terror causes
Night terrors have been noted in kids and adults who are:
- anxious or stressed
- taking a new medicine
- sleeping in a new environment or away from home
- sleep deprived or overtired
- having too much caffeine
- unwell with or without a fever
Sleep terrors sometimes can be triggered by underlying conditions that interfere with sleep, such as obstructive sleep apnoea, restless legs syndrome, excessive alcohol use and mood disorders such as anxiety and depression.
Who gets night terrors
Night terrors are relatively rare and affect only 3%-6% of kids, whereas most kids have had a nightmare. They usually happen in children aged between 4 and 12 and rarely in adults. Most of the time, night terrors simply disappear on their own as the nervous system matures.
Some kids may inherit a tendency for night terrors — about 80% who have them have a family member who also suffered night terrors or sleepwalking (a similar type of sleep disturbance).
Treatment recommendations
Eliminate stress
Anxiety and stress are triggers for night terrors and should be avoided as much as possible. This may involve creating a better work/life/school balance and a calm environment at home. Seek counselling if necessary or have regular talks to your child about anything that might be bothering them.
Get adequate sleep
Night terrors are associated with sleep deprivation and fatigue. It is important to ensure adequate sleep each night and a nap during the day in younger children.
Adults should be aiming for at least 8 hours of sleep and in children at least 10-12 hours depending on their age.
Establish a calming bedtime routine
In adults and children, it is important to establish a relaxing bed time routine to reduce anxiety and promote a good night’s sleep. This can involve a warm bath with magnesium flakes, a few drops of lavender essential oil and candles. Guided meditation, reading a book and having a cut off time for screen devices can also assist in the wind down process before bed.
Safe environment
If sleepwalking or night terrors pose any safety risks, make sure the environment is free from dangerous objects. This can include tripping hazards on the floor, sharp objects, cords, open draws, bunk beds and any sharp objects. If a person sleepwalks make sure all doors and windows are closed and locked.
Let it pass
Although it might appear alarming it is best to not wake a person having a night terror and just let it pass on its own. Often waking a child having a night terror can make them confused and disorientated-making it harder for them to fall back asleep.
Avoid alcohol, nicotine and caffeine
These three substances can interfere with our nervous system—impacting sleep quality. It is recommended to avoid any of these substances 6 hours before bed. Look out for sources of caffeine which can be found in soft drinks, tea, coffee and even chocolate.
Magnesium
Magnesium is an essential mineral helpful for sleep disorders and anxiety. An older study in 27 patients with parasomnias such as night terrors and talking and moving in their sleep found that their symptoms were associated with magnesium deficiency. For best results magnesium can be taken in the morning and at night before sleep to relax the mind and muscles to prevent night terrors.
Calming herbs
Herbal medicines can reduce anxiety and promote a restful night’s sleep. Examples of herbs include chamomile, zizyphus, Californian poppy, lavender, passionflower and kava. They are safe enough to take during the day for anxiety and at night to reduce the incidence of night terrors.
References
- https://www.mayoclinic.org/diseases-conditions/sleep-terrors/symptoms-causes/syc-20353524
- https://kidshealth.org/en/parents/terrors.html
- Petit D, et al. Childhood Sleepwalking and Sleep Terrors: A Longitudinal Study of Prevalence and Familial Aggregation. JAMA Pediatr. 2015 Jul;169(7):653-8 https://www.ncbi.nlm.nih.gov/pubmed/25938617
- Popoviciu L, et al. Parasomnias (non-epileptic nocturnal episodic manifestations) in patients with magnesium deficiency. Rom J Neurol Psychiatry. 1990 Jan-Mar;28(1):19-24 https://www.ncbi.nlm.nih.gov/pubmed/2242333
- Hanus M, et al. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin. 2004 Jan;20(1):63-71 https://www.ncbi.nlm.nih.gov/pubmed/14741074
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